When talking to teens, I complete my HEADS screening with a strength-based approach, which I learned as a med student from Dr. Ginsburg at CHOP. My opening question: "what is something about yourself you're proud of?"

How do you respond if a teen says "I don't know"?
A THREAD This question is so important because adolescent behavior is often filtered through a lens of risks: violence, STIs, pregnancy, etc. While these are important things to address, the first goal is to establish a relationship. Learning about a teen's strengths helps builds rapport.

Why we need to talk about policing of ALL Black folks, not just men:

The #SayHerName hashtag (by @sandylocks) was a call for attention to Black women murdered by police i.e. #MaKhiaBryant and how our expectation that this issue only affects Black men misses the full picture. The African American Policy Forum released a report entitled Say Her Name: Resisting Police Brutality Against Black Women in 2015 to highlight this overlooked issue. Later that same year, #SandraBland died while incarcerated and still ruled a suicide.

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A quick thread about adolescents, marijuana, & equity inspired by today's date:
1) States that have marijuana laws also have teens who report lower perceptions of harm & higher use, but longitudinal studies haven't seen an increase in use post-legalization
pediatrics.aappublications.org/content/145/Su… Here is the current legislative status of marijuana by state. Note: not every state that has decriminalized or legalized marijuana has also expunged the records of previous convictions affecting mostly Black and Brown people.
businessinsider.com/five-states-vo…

It is past due time we talk about microaggressions on interviews (a thread #MedTwitter #AcademicTwitter):

First, microaggressions are harmful! Despite their name, they signal “you don’t belong here” to marginalized groups.

Second, interview days are already nerve-wrecking. One comment or experience has the ability to undermine an interview day. Applicants may not have the ability to report immediately and anonymously or may fear retribution for doing so. Interview day microaggressions put applicants in an awkward spot in addition to the harm.

How to counsel about health w/o talking about weight (@Margaret1473)

First, just bc obesity is associated with a condition doesnt mean its the cause. Correlation doesn’t mean causation! There’s no evidence showing wt loss (isolated from nutrition & exercise) improves health. 2. dieting/weight loss is not sustainable for 9/10 people. Most regain the weight...and risk feeling like failures.

3. Every body has a set point range it likes to maintain. The body works hard to keep it, like increasing hunger on a diet. Yoyo dieting increases the set point😳

Some UIM applicants have approached me about if they should "go there" in an essay or interview aka tell THOSE stories where they witnessed racism at work in healthcare. My thoughts in a thread (I welcome others):

Own the motivation for your interest in health and stay focused. I wrote about an experience in my residency essay and honed in on the patient's condition & what I offered to intervene. The team perceived the family was non-adherent while I saw a a Black mother who was a fierce advocate. I sat with her. I learned about the barrier to follow-up

With in-person rotations back in full swing, it’s time for a thread about managing rough feedback. This is geared towards #MedStudentTwitter, but hopefully applicable to everyone whether you are giving or receiving feedback.

Here we go...
@HollandStanton @m3betch Why I care: I got called “shy”, “unengaged”, a “passive learner”, & a “great pediatrician on my OB rotation”🙃. Critical feedback can hurt. I had to learn how to receive it and also how to change my actions so that the comments reflected my commitment. Thanks to mentors, I did.

Just finished a convo about medical errors. It reminded me of my first real mistake. Thankfully, I was surrounded by a community that helped me learn from it without falling into shame. Culture is SO important for preventing & processing errors. I even wrote this to normalize it: Many don’t have a “good” mistake experience. I was involved in a different situation where learners were blamed instead of taught. I asked an intern to do something that turned out to be incorrect. Our supervisor yelled at the intern w/o acknowledging that they were my directions

#TalkingToTeens101: Let’s Talk About Gender & Sexuality, the #tweetorial

Talking abt gender starts at the beg of the visit. Introduce urself, ur pronouns, then ask patients their name & pronouns.

Ex: “I’m Dr. Fenton & I use she/her pronouns. What name & pronouns do you use?”
1 If a teen is w a parent, ask more privately. I keep it open-ended: “how do you describe your gender?” For teens looking at me confused, I explain like this: “people can identify as male, female, non-binary, a combination, or no gender at all. How do you identify?”
2

Rotating on the peds trauma service, I met a Black young man who was shot in the abdomen. The word was it was “gang activity”. No one bothered to ask more questions.

I walked in the room and saw a boy who was scared. He feared the outcomes of surgery and getting shot again.

1/ He looked anxiously at his mother whenever she came to his bedside. With tough love in her eyes, she explained that she asked him to move out and live with an older brother due to conflicts at home. Her expression seemed to question if she made the right decision

2/